A member asked:

Is it possible to have severe pcos but without insulin resistance & being overweight? if so how likely is this & what is recommended for symptoms in this case if patient does not tolerate the pill & spironolactone does not do much?

A doctor has provided 1 answer

Documented PCOS is best treated with oral BCP's, so the constant estrogen production without ovulation is stopped, which preserves fertility options later, and also prevents long term estrogen effects on the uterine lining, which can cause cancerous changes albeit rarely.

Answered 7/27/2021

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